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New Study Estimates More than One Million New Yorkers Would Become Uninsured Under ACA Repeal

The Urban Institute released a new report today, which examines the implications of a partial repeal of the Affordable Care Act (ACA) through a process known as budget reconciliation. According the report’s findings, more than 1.1 million New Yorkers would become uninsured by 2019 under a partial repeal of the ACA.

New York State also stands to lose substantial funding from the federal government:

The Urban Institute estimates that New York would lose more than $10 billion by 2028 in premium tax credits and cost-sharing reductions, which help make health insurance more affordable for individuals and families.

The Urban Institute also estimates that New York would lose approximately $47 billion by 2028 in funding for Medicaid and the Children’s Health Insurance Program (CHIP).

Although not included in the study, New York would also lose funding for its Basic Health Plan, branded the Essential Plan, which currently insures nearly 600,000 people.

Nationally, the number of uninsured is estimated to increase by 103 percent or 29.8 million people by 2019 under partial repeal. It is also estimated that there would be 12.9 million fewer people with Medicaid and CHIP coverage in 2019.

If you or someone you know would be affected by any of these issues, please share your story.

Under the Affordable Care Act (ACA), 20 million Americans have enrolled in health insurance, and the uninsured rate has sunk to the lowest level on record. In New York, our ACA marketplace, the New York State of Health, has enrolled more than 2.8 million New Yorkers into high quality affordable coverage. New York’s uninsurance rate was cut in half between 2013 and 2015.

The ACA provides free coverage or subsidized coverage to the vast majority of New Yorkers obtaining coverage on the NY State of Health marketplace. The new Essential Plan provides free or low-cost coverage to almost 600,000 New Yorkers. The ACA also makes insurance work better for consumers. The extensive list of consumer protections it offers includes: preventive care with no cost-sharing; an end to lifetime and annual limits; a prohibition on discrimination in health care; and no more denials or delays of coverage because of pre-existing conditions.

HCFANY knows that many consumers woke up this morning worrying about whether they will lose the coverage they count on because of threats to repeal the ACA.

HCFANY calls on our elected leaders to assuage their fears and act as soon as practicable to maintain the advances in coverage that New Yorkers have received since the ACA was enacted. New York has always been a leader on health coverage issues. We look to the leadership of New York State to continue to find ways to provide quality, affordable coverage for all New Yorkers.

Open enrollment for 2017 coverage continues, and consumers should enroll or renew their coverage at the NY State of Health. Navigators are also available to help consumers review their options.

Guest blog by Lois Uttley, MPP, Director of Raising Women’s Voices-NY. Six years after the Affordable Care Act (ACA) was signed into law and three years after the ACA insurance marketplaces opened, the nation’s uninsured rate has dropped to the lowest level ever recorded. Between 2010 and 2016, the percentage of people without health insurance fell by nearly half, from 16 percent to 8.6 percent. The sharp decline is illustrated in this chart from Vox. The previous low of 9.1 percent was recorded in 2015.

The new numbers were released last week by the National Center for Health Statistics, and are based on the National Interview Survey conducted during the first quarter of 2016. The survey uncovered some important variations among population groups when it comes to health insurance. For example:

Only 5 percent of children 17 and younger are now uninsured. Of those, 42.1 percent had public coverage and 54.9 percent had private coverage.

Hispanic adults had the greatest decline in un-insurance, going from 40.6 percent in 2013 to 24.5 percent in 2016. But that reduced rate was still much higher than the 2016 rates for non-Hispanic Black (13 percent), white (8.4 percent) and Asian adults (6.7 percent).

States Fully Implementing the ACA Show Biggest Drop In Uninsured

The national survey data also reveal striking disparities between rates of un-insurance in states like New York that have fully implemented the ACA – by expanding their Medicaid programs and creating their own health insurance exchanges, or marketplaces – and those that have refused to do so because of conservative political opposition.

First, let’s look at the impact of a state’s decision to expand Medicaid. In the expansion states, the percentage of uninsured adults (ages 18 to 64) dropped by half — from 18.4 percent in 2013 to 9.2 percent in 2016. By contrast, in non-expansion states, the uninsured rate fell somewhat – from 22.7 percent in 2013 to 16.7 percent in 2016 — but still remained high.

Next, let’s look at the difference in uninsured rates between states that opened their own marketplace (or partnered with the federal government to create a marketplace) and those states that refused to do so, and instead defaulted to having a federally-run marketplace. There have been significant declines in uninsured rates in states with their own marketplaces (from 18.7 percent in 2013 to 9.1 percent in 2016) and in partnership marketplace states (from 17.9 percent in 2013 to 8.2 percent this year).

The survey found a different story in the states with federally-run marketplaces. Although even those states experience a drop in the uninsured rate (from 22 percent to 14.5 percent), the 2016 percentage of residents who remain uninsured is much higher than in the other states.

Once again New York is leading the nation as one of only two states to implement a Basic Health Plan (BHP). As of January 31, 379,599 New Yorkers enrolled in comprehensive, affordable coverage through the New York’s BHP, branded the Essential Plan, which launched in 2016. A few weeks ago, the NY State of Health (NYSOH) released its report on the third open enrollment period, which ran from November 1, 2015 through January 31, 2016. HCFANY is excited to see so many consumers gaining access to health care through the EP in its first year.

The EP is meeting an important need for consumers in New York, particularly for those with incomes between 138 and 200 of the Federal Poverty Level (FPL). Before the implementation of the Essential Plan, individuals at this income level would only have been eligible to purchase Qualified Health Plans (QHP) with financial assistance, and many continued to face financial barriers to coverage. With the EP, low- and moderate income individuals can now receive coverage comparable to that of a QHP for a premium of $0 or $20 and no annual deductible. The average consumer saves over $1,100 compared to QHP coverage. This increased affordability has resulted in high enrollment levels for EP eligible individuals. According to NYSOH’s open enrollment report, 98 percent of individuals determined to be eligible for the Essential Plan enrolled compared to only 58 percent of individuals eligible for QHP.

Essential Plan coverage is also available to individuals under age 65 with incomes below 138 percent of the Federal Poverty Level (FPL) who are lawfully present in the United States, but have not met the five-year bar to qualify for Medicaid as well as lawfully present immigrants with incomes 138 to 200 percent of FPL.

Like Medicaid and Child Health Plus, individuals and families eligible for the EP can enroll throughout the year.